A 65-year-old lady presented with postmenopausal bleeding. TVS showed thick endometrium > 5 mm. What is the next management plan? A) Hysteroscopy biopsy B) In-patient hysteroscopy... A 65-year-old lady presented with postmenopausal bleeding. TVS showed thick endometrium > 5 mm. What is the next management plan? A) Hysteroscopy biopsy B) In-patient hysteroscopy C) Out-patient endometrial sampling D) LNG-IUS
Understand the Problem
The question describes a postmenopausal woman presenting with postmenopausal bleeding and a thickened endometrium on transvaginal ultrasound (TVS). It asks for the next appropriate management step. This requires knowledge of gynecological guidelines for investigating postmenopausal bleeding.
Answer
Outpatient endometrial sampling.
The next step in managing a 65-year-old lady with postmenopausal bleeding and a thickened endometrium (>5mm) on TVS is outpatient endometrial sampling.
Answer for screen readers
The next step in managing a 65-year-old lady with postmenopausal bleeding and a thickened endometrium (>5mm) on TVS is outpatient endometrial sampling.
More Information
In postmenopausal women with bleeding, if TVS shows an endometrial thickness of 4mm or greater, endometrial biopsy should be performed.
Tips
It is important to check endometrial thickness via TVS. If TVS is not possible, proceed to hysteroscopy.
Sources
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